Provider Demographics
NPI:1689895427
Name:TRENTON COMMUNITY CLINIC PHARMACY
Entity Type:Organization
Organization Name:TRENTON COMMUNITY CLINIC PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY INFORMATICS CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:602-364-5277
Mailing Address - Street 1:331 4TH AVE E
Mailing Address - Street 2:PO BOX 210
Mailing Address - City:TRENTON
Mailing Address - State:ND
Mailing Address - Zip Code:58853-9998
Mailing Address - Country:US
Mailing Address - Phone:701-774-0461
Mailing Address - Fax:701-774-8033
Practice Address - Street 1:331 4TH AVE E
Practice Address - Street 2:HWY 1804
Practice Address - City:TRENTON
Practice Address - State:ND
Practice Address - Zip Code:58853-9998
Practice Address - Country:US
Practice Address - Phone:701-774-0461
Practice Address - Fax:701-774-8033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3503934OtherNCPDP NUMBER
ND1312TRMedicaid
ND1312TRMedicaid